Application for License

General Information

Type of License(required)
Applicant Name(required)
Date(s) of Event (if applicable)
Applicant is(required)
GIVE THE NAMES, LEGAL RESIDENCE ADDRESS, AND DATE AND PLACE OF BIRTH FOR EACH INDIVIDUAL, PARTNER OR CORPORATE/OFFICER/DIRECTER (ENTER N/A FOR EXTRA SPACES):
Applicant 1(required)
Applicant 2
Applicant 3
Applicant 4
Applicant 5
Applicant 6
Business Name (d/b/a)(required)
Business Location(required)
Mailing Address(required)
City, State, Zip(required)
Telephone(required)
The Applicant understands and agrees that the City of Rutland and the Rutland City Police Department may obtain criminal History Record information from state and federal record repositories prior to acting on this application. The Applicant agrees to comply with all provisions of the Revised Ordinances of the City of Rutland and the laws of the State of Vermont.
Signature of authorised agent of corporation, club or association
Signature(s) of Individual or Partners
Title
Date

Downtown Rutland Partnership